MEDPAGE TODAY: In a paper published in the Annals of Internal Medicine, Matthew DeCamp, MD, PhD, and co-authors seek to help practicing physicians understand, even more clearly than they already do, just how important the standards for the determination of death are.
Advances in re-establishing postmortem circulation through extracorporeal membrane oxygenation (ECMO) or normothermic regional perfusion -- a transplant protocol emerging in U.S. hospitals -- have made the dichotomy between the circulatory and brain criteria of the 1980 definition in the Uniform Determination of Death Act more consequential.
"The determination of death is something that happens every day. It is a profound and solemn act that physicians and other clinicians engage in," DeCamp said. "They intersect the fundamental values of the profession -- values like honesty, transparency, integrity, and respect."
DALLAS MORNING NEWS: “It raises questions about justice and fairness, because now the burden of providing medical education is falling disproportionately on vulnerable and marginalized members of society,” said Matthew DeCamp, MD, PhD. “Anatomy lab is often one of the most profound and important experiences a student can have, not just because of learning anatomy but also because of learning some of the fundamental values of the medical profession and respecting human dignity,”
Just how many unclaimed bodies are used in medical education is difficult to pinpoint. DeCamp co-authored a 2019 study that surveyed 146 U.S. medical schools on the use of unclaimed bodies, of which only 89 responded. Eleven schools reported possible use of unclaimed bodies, although programs differed on whether they believed students should be informed of unclaimed body use.
RADx-UP/NIH: "Research, Engagement, and Action on COVID-19 (REACH-OUT) is a community-based study,” said Matthew DeCamp, MD, PhD. “We involve the community in both design and the implementation of our study to address social, ethical, and behavioral barriers to COVID-19 testing.”
The team, including Quatisha Bailey, MA, from Children’s Hospital Colorado, conducted 250 surveys in a three-week timeframe,” and found themes that stuck out were trust and distrust, health care access, and awareness around COVID-19. “Trust is everything,” said Bailey. “And how to establish trust, regain trust, and maintain trust is language. We have to speak in a language that people understand.”
COLORADO SUN: When the state of North Dakota passed a law requiring abortion providers to inform patients that it may be possible to “reverse” a medication abortion, Center Director, Matthew Wynia, MD, MPHspoke out against it. “It's a terrible idea to try to legislate medical practice.” says Wynia.
“This misrepresentation will serve to mislead or coerce patients who want to ‘undo’ a medication abortion to participate in an unethical experiment without their knowledge,” Wynia wrote in a declaration filed in a lawsuit seeking to stop the law. “For physicians who are forced to deliver a misleading and inaccurate message that might cause their patients to enroll in an experiment without their full knowledge, doing so is highly unethical.”
CU ANSCHUTZ TODAY: “The laws we have and the laws we don't have… have an enormous impact on who gets sick to begin with. And they determine, literally, who lives and who dies sometimes, and who lives with what degrees of preventable illness." said Daniel Goldberg, JD, PhD, director of education at the Center for Bioethics and Humanities and director of the new Public Health Ethics & Law Program (PHEAL) at the Colorado School of Public Health.
The experience of living and breathing through a pandemic brought many ethical and legal issues to the forefront, and we have to deal with these as a society in order to try to keep ourselves and the world healthy and protect the most vulnerable. That's why now is precisely the right time for the Colorado School of Public Health and Center for Bioethics and Humanities to launch the Public Health Ethics and Law Program.
CU SCHOOL OF MEDICINE WHITE COAT CEREMONY: Matthew Wynia, MD, MPH, FACP Professor, Department of Medicine and Director of the CU Center for Bioethics and Humanities delivered the keynote address to the incoming 184 aspiring physicians, as well as hundreds of family, friends, and faculty who will join them on their journey. Dr. Wynia also was recognized with the 16th Annual Faculty Professionalism Award, which was presented by Abigail Lara, MD, Associate Professor, Department of Medicine Director, Office of Faculty Relations.
NATURE: Investigations suggest that, in some fields, at least one-quarter of clinical trials might be problematic or even entirely made up, warn some researchers. They urge stronger scrutiny. Lisa Bero, PhD and colleagues acknowledge trustworthiness checks are sometimes unfair to the authors of randomized controlled trials, and exactly what should be checked to classify untrustworthy research, is still up for debate. Bero and a team of research-integrity experts have developed a set of red flags that might serve as the basis for creating a widely agreed method of assessment.
SCIENCE: Artificial intelligence (AI) shows promise for improving basic and translational science, medicine, and public health, but its success is not guaranteed. Numerous examples have arisen of racial, ethnic, gender, disability, and other biases in AI applications to health care. Co-authors Matthew DeCamp, MD, PhD and Charlotta Lindvall, MD, PhD write that ensuring equity will require more than unbiased data and algorithms. It will also require reducing biases in how clinicians and patients use AI-based algorithms—a potentially more challenging task than reducing biases in algorithms themselves.
AMERICAN MEDICAL ASSOCIATION: Center Director Matthew Wynia, MD, MPH, received the AMA Foundation Award for Leadership in Medical Ethics and Professionalism. Matt is one of 11 physicians to recieve an Excellence in Medicine Award at the AMA's June, 2023 meeting in Chicago, where he was recognized for his altruism, advocacy and professional skill, The award honors people dedicated to the principles of medical ethics and the highest standards of medical practice and who have made an outstanding contribution through active service in medical ethics activities.
Dr. Wynia also was named as co-chair, along with Niva Lubin-Johnson, MD, MPH, of a task force to guide organizational transformation within and beyond the AMA toward restorative justice to promote truth, reconciliation, and healing in medicine and medical education.
HARVARD HUMAN RIGHTS JOURNAL: As we approach the 100th anniversary of children’s rights, in which the Geneva Declaration of the Rights of the Child stated that humanity “owes to the child the best that it has to give," this commentary by Warren Binford, JD, Ed.M, affirms the U.S. has a moral duty to more fully integrate children into our national priorities and decision-making.
Children comprised 22.1 percent of the U.S. population in 2020 and yet just 7.4 percent of the federal budget was allocated for their needs. It is only when children are able to fully exercise their political rights that their needs will start to be addressed by a system that too often has dismissed them as merely children, and as a result, under-resourced them and their future.
WASHINGTON POST: Withholding information for the patient’s best interest was the norm in medicine for centuries. Doctors were the gatekeepers of health and their duty was to provide hope and comfort. Currently the doctor-patient partnership model has replaced that sort of medical paternalism. Yet doctors still make routine judgments about how much to tell patients.
Too much information can be unhelpful and confusing, said CBH Research Director, Eric Campbell, PhD. Should a doctor decide that medical choices are over a patient’s head so they shouldn’t be mentioned or that a patient is too fragile to handle difficult news? Such assumptions can reflect an implicit bias that can lead to health disparities. Poorer outcomes can result when a doctor’s unconscious feelings about skin color, gender, disability, age or ethnicity influence what gets shared.
CU ANSCHUTZ NEWS: Senator John Hickenlooper and Federal Drug Administration (FDA) Commissioner Robert Califf, MD, visited our campus on June 23rd. Following a tour of the Gates Manufacturing Facility, a group of researchers and CBH Director Matthew Wynia, MD, MPH, came together to discuss insights into pandemic preparedness with Hickenlooper and Califf, whose son graduated from the University of Colorado School of Medicine and practices in Colorado.
Hickenlooper, is a member of the Senate Health, Education, Labor & Pensions Committee, is currently working on the reauthorization of the Pandemic and All Hazards Preparedness Act (PAHPA). That legislation addresses agencies, including preparedness programs at the FDA, Biomedical Advanced Research and Development Authority, the Administration for Strategic Preparedness and Response and other public health infrastructure programs.
NASEM: Chief Scientist Lisa Bero, PhD was the keynote presenter at a 3-day National Academies of Sciences, Engineering and Medicine Workshop on the many ways that funding sources (especially corporate funders) can influence and impair research quality and outcomes.
THE MESSENGER: Researchers Nadia Gaber, Lisa Bero, and Tracey J. Woodruff analyzed a trove of previously secret documents initially uncovered during litigation by Robert Bilott, the first attorney to successfully sue DuPont over PFAS. Bero and colleagues found that by “suppressing unfavorable research and distorting public discourse, 3M and DuPont were able to tamp down wider concern for decades, using strategies similar to Big Tobacco to keep the risks quiet."
Their findings and implications for policy makers & the public were published in an article in the Annals of Global Health entitled, The Devil they Knew: Chemical Documents Analysis of Industry Influence on PFAS Science.
NATURE: Most people think about their genes as being uniquely identifiable to them. But new research by a team including Matthew DeCamp, MD, PhD and Marilyn Coors, PhD, shows that your " proteome "- the full set of proteins that are made from your genes, and include everything from blood cells to neurons to proteins like insulin - are just as unique.
They found that even with only a modest number of proteins, researchers can link people to their genome with remarkable accuracy - meaning the proteome is not as anonymous as once thought.
CU ANSCHUTZ NEWS: Matthew DeCamp, MD, PhD, and colleagues are shining a light on artificial intelligence’s role — and appearance — in health care. “Sometimes overlooked is what a chatbot looks like – its avatar,” the researchers write in a new paper published in Annals of Internal Medicine. “Current chatbot avatars vary from faceless health system logos to cartoon characters or human-like caricatures. Chatbots could one day be digitized versions of a patient’s physician, with that physician’s likeness and voice. Far from an innocuous design decision, chatbot avatars raise novel ethical questions about nudging and bias.”
NEWS NATION: The Indiana Medical Licensing Board voted to reprimand Dr. Caitlin Bernard, an Indianapolis obstetrician-gynecologist, after she spoke to the press about providing an abortion to a 10-year-old rape victim from Ohio.
NewsNation host Dan Abrams says there’s “no way” anyone would be able to identify the patient based on the information disclosed by the doctor. Center Director Matthew Wynia, MD, MPH, weighed in stating, " This is an illustration that medical ethics and journalistic ethics worked in this case. What did not work in this case is political ethics."
CU ANSCHUTZ NEWS: Lisa Bero, PhD, Chief Scientist at CBH and Research Professor at the the Colorado School of Public Health, recently led a National Academies of Sciences, Engineering and Medicine committee to improve processes that the Environmental Protection Agency (EPA) uses to identify harm posed to humans and the environment following industrial chemical spills. “Harm is something that I think gets conflated with safety,” said Bero.
“Established levels for a chemical’s harm don’t necessarily mean that if you’re slightly outside that level, it’s safe. And it further depends on the data as well, which is always limited. For example, liver toxicity studies are often done acutely – high levels of exposure in a short period of time – rather than at lower levels over an extended period," Bero said.
THE MILBANK QUARTERLY: Daniel Goldberg, JD, PhDand co-authors find that medicalization defines behavioral and physiological responses to social phenomena as individual pathology and disease (often with elements of stigma and social control), which are in turn viewed as individual medical problems to be diagnosed, treated, and influenced by authorities within the field of medicine.
Medicalization has encroached into both population health science and public health, bringing with it a myopic focus on the role of the medical care delivery system in intervening upon individual acute medical and social needs. This leaves the root-cause social, economic, and political drivers of population health invisible, ignored, and undisturbed.
NEW YORK TIMES: For the past decade, the White House and Congress have relied on the National Academies of Sciences, Engineering and Medicine, a renowned advisory group, to help shape the federal response to the opioid crisis, by convening expert panels or delivering policy recommendations and reports. Yet officials with the National Academies have kept quiet about one thing: their decision to accept roughly $19 million in donations from members of the Sackler family, the owners of Purdue Pharma, the maker of the drug OxyContin that is notorious for fueling the opioid epidemic.
CBH Chief Scientist Lisa Bero, PhD, said the group’s longtime failure to disclose financial ties between committee members and industry placed the Academies in the “dark ages” of research integrity. Accepting millions of dollars from the Sackler family while advising the federal government on pain policy “would be considered a conflict of interest under almost any conflict-of-interest policy I’ve ever seen.”